Verrucous Hyperplasia

considerable acanthosis with broadened rete ridges causes deprivation of distant epithelial cells from blood supply and appearance becomes edematous and swollen. These necrotic cells undergo desquamation. Also leaving cleft in the surface of the epithelium. Verrucous projections are formed in this way in between clefts. At a later stage both the verrucous projections and the clefts undergo keratinization [5].
This is a case of verrucous hyperplasia with candidal superinfection in a background of early oral submucous fibrosis. OSF is a precancerous condition associated with chronic betel and areca nut chewing. A clear dose dependent relationship was observed for both frequency and duration of chewing areca nut in development of OSF [10]. Fibrosis is resulted by increased collagen synthesis or reduced collagen degradation. Development of squamous cell carcinoma
Surgery is the most common treatment modality. The use of radiotherapy is controversial. The conventional treatment of oral verrucous hyperplasia is total surgical excision.
Recurrence and/or transformation of oral verrucous hyperplasia to either verrucous carcinoma or conventional SCC have been report after surgical intervention. Shear and Pindborg had reported recurrence in four of their patients with lesions showing both verrucous hyperplasia and verrucous carcinoma [4]. According to clinico pathological study done by HazareyVK et al. 13 cases were treated with surgical excision. Two cases were treated with lasers. Few showed evidence of recurrence after excision. Laser operated two cases showed recurrence within one year of follow-up [9]. Wide surgical excision of the primary verrucous lesion with adequate mucosal and soft-tissue margin is necessary to avoid local recurrence [5].